Comparison of LC-MS/MS and chemiluminescent immunoassays for immunosuppressive drugs reveals organ dependent variation in blood cyclosporine a concentrations

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Becker , A , Backman , J T & Itkonen , O 2020 , ' Comparison of LC-MS/MS and chemiluminescent immunoassays for immunosuppressive drugs reveals organ dependent variation in blood cyclosporine a concentrations ' , Clinica Chimica Acta , vol. 508 , pp. 22-27 . https://doi.org/10.1016/j.cca.2020.05.007

Title: Comparison of LC-MS/MS and chemiluminescent immunoassays for immunosuppressive drugs reveals organ dependent variation in blood cyclosporine a concentrations
Author: Becker, Anna; Backman, Janne T.; Itkonen, Outi
Other contributor: University of Helsinki, HUSLAB
University of Helsinki, HUSLAB
University of Helsinki, Department of Clinical Chemistry and Hematology









Date: 2020-09
Language: eng
Number of pages: 6
Belongs to series: Clinica Chimica Acta
ISSN: 0009-8981
DOI: https://doi.org/10.1016/j.cca.2020.05.007
URI: http://hdl.handle.net/10138/329826
Abstract: Introduction: Life-long monitoring of immunosuppressive drugs (ISDs) in blood is essential after organ transplantation. However, the ISD concentrations vary depending on the assay employed. ISDs are strongly bound to cytoplasmic proteins in erythrocytes in circulation. Therefore, the relatively rapid sedimentation of blood cells in whole blood samples may affect the results when using liquid handling robots. Methods: We used 1115 blood samples from outpatients and ward patients with kidney (n = 373), liver (n = 101), heart (n = 29) and bone marrow (n = 155) transplant. Whole blood samples were pretreated by protein precipitation. Alternatively, the samples were hemolyzed by freezing prior to precipitation. ISDs were analyzed by a 2-plexing liquid chromatography tandem mass spectrometry (LC-MS/MS) assay and commercial chemiluminescent microparticle immunoassays (CMIA). Results: The difference between the two sample preparation practices was negligible (<2%). Overall, the measured ISD concentrations in patient samples were lower by LC-MS/MS than by CMIA. The difference was the largest (20.2%) and the smallest (9.1%) in samples from liver and from heart transplant patients, respectively. Conclusions: CMIA overestimates blood ISD concentrations as compared to LC-MS/MS. The extent of the difference was found to be organ transplant dependent. The ISDs can be quantitated either from intact or hemolyzed blood samples.
Subject: Immunosuppressive drugs
LC-MS/MS
CMIA
Blood cell sedimentation
MULTISITE ANALYTICAL EVALUATION
ANALYTICAL PERFORMANCE
TACROLIMUS ASSAY
BONE-MARROW
KIDNEY
LIVER
HEART
METABOLISM
SIROLIMUS
3111 Biomedicine
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